Combined Psychophysical Approach to Pharmaco-therapeutic Management of Chronic Pain: A Review

Abstract

Pain is a vital symptom which symbolizes the body’s response to injury. The pathophysiology of pain from the site of the injury or pathology to its perception in the brain involves multiple pathways and mediators. Therefore it is increasingly being recognized that a single or unidimensional approach may not give the desired improvement in the quality of life of the patient with chronic pain. Chronic pain is often accompanied by psychological components and symptoms such as anxiety, depression and sleep disturbances which also further aggravate and exaggerate the pain, increase the disability days and severely impact quality of life. Therefore, a holistic approach to chronic pain management as seen in distressing neuropathic and musculoskeletal pain conditions like peripheral neuropathy, neuralgias, fibromyalgia, and spondylopathies, would require pharmacotherapy at both physical and psychological levels to give the desired improvement in both pain and quality of life of these patients. Drugs like Pregabalin and Gabapentin combined with Antidepressants can not only alleviate pain symptoms but can also improve the psychological component of associated anxiety and depression as well as improve sleep. Therefore such a combination approach can be one of the pharmaco-therapeutic ways of a psychophysical approach in patients with the above mentioned painful conditions.